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Common Genetic Variants of MUTYH are not Associated with Cutaneous Malignant Melanoma: Application of Molecular Screening by Means of High-Resolution Melting Technique in a Pilot Case-Control Study. Int J Biol Markers 2018; 26:37-42. [DOI: 10.5301/jbm.2011.6285] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/10/2010] [Indexed: 01/09/2023]
Abstract
MUTYH glycosylase recognizes the 8-oxoG:A mismatch and is able to excise the adenine base using proofreading mechanisms. Some papers have reported a strong association between cancer development or aggressiveness and MUTYH gene mutations. The aim of this study was to find a possible association between the most frequent MUTYH mutations and melanoma in the context of a case-control pilot study. One hundred ninety-five melanoma patients and 195 healthy controls were matched for sex and age. Clinical and laboratory data were collected in a specific database and all individuals were analyzed for MUTYH mutations by high-resolution melting and direct sequencing techniques. Men and women had significantly different distributions of tumor sites and phototypes. No significant associations were observed between the Y165C, G382D and V479F MUTYH mutations and risk of melanoma development or aggressiveness. Our preliminary findings therefore do not confirm a role for MUTYH gene mutations in the melanoma risk. Further studies are necessary for the assessment of MUTYH not only in melanoma but also other cancer types with the same embryonic origin, in the context of larger arrays studies of genes involved in DNA stability or integrity.
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Neutrophil-to-lymphocyte Ratio (NLR) as a predictor for recurrence in patients with stage III melanoma. Sci Rep 2018; 8:4044. [PMID: 29511262 PMCID: PMC5840418 DOI: 10.1038/s41598-018-22425-3] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2017] [Accepted: 02/22/2018] [Indexed: 12/22/2022] Open
Abstract
Neutrophil-to-lymphocyte ratio is a strong predictor for overall survival and disease free survival in many cancers. Our study is the first investigation aiming to determine the predictive value of neutrophil-to-lymphocyte ratio on prognosis of patients with stage III melanoma. This retrospective study utilized a cohort of 107 patients with stage III melanoma treated at Huntsman Cancer Institute, University of Utah, from May 2002 to March 2016. The optimal cutoff of neutrophil-to-lymphocyte ratio was determined by the significance of log-rank tests. A total of 97 log-rank tests were conducted to find the optimal cutoff. Disease free survival was assessed using the Kaplan–Meier method, and univariable and multivariable Cox models were applied to evaluate the predictive value of neutrophil-to-lymphocyte ratio. 2.5 was identified as the optimal cutoff. Kaplan–Meier curve showed that the disease free survival rate of the low value group was significantly higher compared to that of high value group. After adjusting for confounders and other prognostic factors, the neutrophil-to-lymphocyte ratio ≥ 2.5 remained a strong predictor for disease recurrence in patients with stage III melanoma.
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Wu YP, Nagelhout E, Aspinwall LG, Boucher KM, Parsons BG, Kohlmann W, Kaphingst KA, Homburger S, Perkins RD, Grossman D, Harding G, Leachman SA. A novel educational intervention targeting melanoma risk and prevention knowledge among children with a familial risk for melanoma. PATIENT EDUCATION AND COUNSELING 2018; 101:452-459. [PMID: 29078964 PMCID: PMC5935504 DOI: 10.1016/j.pec.2017.10.008] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/18/2017] [Revised: 10/06/2017] [Accepted: 10/14/2017] [Indexed: 05/08/2023]
Abstract
OBJECTIVE To examine the acceptability of and preliminary effects associated with a novel educational intervention for children at elevated risk for melanoma. The intervention incorporated information on mechanisms through which melanoma preventive behaviors mitigate risk for melanoma and was delivered to parents and children concurrently. METHODS Twenty-two parents (with a personal history of melanoma or spouse with a history of melanoma) and 33 children (mean age 11.8 years) were asked to complete questionnaires immediately prior to and after an educational session and at a one-month follow-up. RESULTS Both parents and children endorsed that the educational materials were acceptable. Knowledge about melanoma risk and preventive and screening behaviors increased significantly. Children's perceived risk for melanoma increased significantly, while parents' perceptions of children's risk started at a higher level and remained constant. There were significant increases in reported engagement in sun protective behaviors. CONCLUSION The educational intervention shows promise in terms of its acceptability and effects on participant knowledge, perceived risk, and engagement in melanoma preventive behaviors. PRACTICE IMPLICATION Children at elevated risk for melanoma and their parents may benefit from receiving educational information on their disease risk and strategies for prevention and screening.
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Affiliation(s)
- Yelena P Wu
- Department of Dermatology, University of Utah, 30 North 1900 East, 4A330, Salt Lake City, UT 84132; Huntsman Cancer Institute, 2000 Circle of Hope, Rm 4509, Salt Lake City, UT 84112, USA.
| | - Elizabeth Nagelhout
- Department of Dermatology, University of Utah, 30 North 1900 East, 4A330, Salt Lake City, UT 84132
| | - Lisa G Aspinwall
- Department of Psychology, University of Utah, 380 South 1530 East, Room 502, Salt Lake City, UT 84112, USA
| | - Kenneth M Boucher
- Huntsman Cancer Institute, 2000 Circle of Hope, Rm 4509, Salt Lake City, UT 84112, USA
| | - Bridget G Parsons
- Huntsman Cancer Institute, 2000 Circle of Hope, Rm 4509, Salt Lake City, UT 84112, USA
| | - Wendy Kohlmann
- Huntsman Cancer Institute, 2000 Circle of Hope, Rm 4509, Salt Lake City, UT 84112, USA
| | - Kimberly A Kaphingst
- Huntsman Cancer Institute, 2000 Circle of Hope, Rm 4509, Salt Lake City, UT 84112, USA; Department of Communication, University of Utah,255 S Central Campus Drive, Room 2400, Salt Lake City, UT 84112, USA
| | - Sheila Homburger
- Genetic Science Learning Center, University of Utah, 515 100 S, Salt Lake City, UT 84102, USA
| | - Ryan D Perkins
- Genetic Science Learning Center, University of Utah, 515 100 S, Salt Lake City, UT 84102, USA
| | - Douglas Grossman
- Huntsman Cancer Institute, 2000 Circle of Hope, Rm 4509, Salt Lake City, UT 84112, USA; Department of Dermatology & Knight Cancer Institute, Oregon Health & Science University,3303 SW Bond Avenue, Portland, OR 97239, USA
| | - Garrett Harding
- Huntsman Cancer Institute, 2000 Circle of Hope, Rm 4509, Salt Lake City, UT 84112, USA
| | - Sancy A Leachman
- Department of Dermatology & Knight Cancer Institute, Oregon Health & Science University,3303 SW Bond Avenue, Portland, OR 97239, USA
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Tan MG, Nag S, Weinstein M. Parental use of sun protection for their children-does skin color matter? Pediatr Dermatol 2018; 35:220-224. [PMID: 29436037 DOI: 10.1111/pde.13433] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
BACKGROUND/OBJECTIVES Excessive sun exposure during childhood is a risk factor for skin cancer. This study aimed to compare the frequency of ideal sun protection use between parents with lighter- and darker-skinned children and explore their attitudes and beliefs on sun safety and their choice of sun protection. METHODS Parents of children aged 6 months to 6 years completed self-administered questionnaires about sun protection practices for their children. Parents assessed their child's Fitzpatrick phototype and were divided into lighter- (Fitzpatrick phototype I-III) and darker-skinned (Fitzpatrick phototype IV-VI) groups. Sun safety guidelines from the Canadian Dermatology Association were used to qualify ideal sun protection. RESULTS A total of 183 parents were included. Overall, 31 parents (17%) used ideal sun protection for their children. As their children grew older, parents were less likely to use ideal sun protection (odds ratio = 0.69, 95% confidence interval = 0.53-0.90). Parents in the lighter-skinned group were more likely to use ideal sun protection for their children (odds ratio = 7.4, 95% confidence interval = 2.7-20.1), believe that sun exposure was harmful (odds ratio = 17.2, 95% confidence interval = 4.0-74.9), and perceive value in sun protection (odds ratio = 11.4, 95% confidence interval = 3.3-39.0); the darker-skinned group believed that darker skin tones provided more sun protection (odds ratio = 12.4, 95% confidence interval = 6.1-25.4). CONCLUSION Ideal parental sun protection efforts are overall low, particularly in parents of darker-skinned children. The identified attitudes toward and beliefs about sun safety may aid in delivery of future sun protection interventions, especially in multiracial populations.
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Affiliation(s)
- Marcus G Tan
- Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Shudeshna Nag
- Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Miriam Weinstein
- Division of Pediatric Medicine, Section of Dermatology, The Hospital for Sick Children, Toronto, Ontario, Canada
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Littlewood Z, Greenfield S. Parents' knowledge, attitudes and beliefs regarding sun protection in children: a qualitative study. BMC Public Health 2018; 18:207. [PMID: 29391005 PMCID: PMC5796497 DOI: 10.1186/s12889-018-5091-8] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2017] [Accepted: 01/17/2018] [Indexed: 11/25/2022] Open
Abstract
Background Childhood is a critical period for sun protection, when the skin is particularly susceptible to the carcinogenic effects of ultraviolet radiation. Children are dependent upon parents to implement sun protective measures. Existing qualitative research exploring parents’ attitudes and beliefs underpinning children’s sun protection is from Australia, which has the highest melanoma incidence rates globally, and thus benefits from widespread sun protection awareness campaigns. Parents’ sun protective behaviour may, therefore, differ between Australia and the UK. This study investigates the topic in a UK context, using qualitative methodology to gain detailed insights into a relatively under-researched area. The aim of the study was to explore parents’ knowledge and understanding of sun protection in children, and factors that motivate and challenge them in this area. Finally, it aimed to determine if and how ethnicity and skin type influence these attitudes and beliefs. Methods Twenty-two semi-structured individual interviews were carried out with parents of children aged 5 years or younger, recruited from local nurseries. Transcripts were analysed using thematic analysis. Results Four overarching themes emerged, each incorporating two to three sub-themes. ‘Attitudes towards children’s sun protection’ refers to the fact that parents considered sun protection to be important for children, a finding which was consistent between different skin types. ‘Sun protection practices’ brings together several protective behaviours adopted in children and, to a lesser degree, in parents, and their associated disadvantages. ‘Sun safety knowledge’ refers to parents’ awareness of the risks of sun exposure and the need for protection, and illustrates where gaps in knowledge exist, such as regarding the need for vitamin D, and the importance of vigilant sun protection even in the UK. Finally, ‘motivating and facilitating factors’ highlights motivations for sun protection in children, and factors that facilitate it in practice. Conclusion This study found parents to be motivated and concerned about children’s sun protection, irrespective of children’s ethnicity, and aware of appropriate protective behaviours. It indicates key challenges which could be targeted in future campaigns in order to improve sun protection in children and reduce uncertainty and anxiety regarding sun safety amongst parents. Electronic supplementary material The online version of this article (10.1186/s12889-018-5091-8) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Zoe Littlewood
- College of Medical and Dental Sciences, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK
| | - Sheila Greenfield
- Institute of Applied Health Research, College of Medical and Dental Sciences, Murray Learning Centre, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK.
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Wright B, Winslade M, Dudley D, Cotton W, Hamer A. Protect your skin and let the fun begin: The results of an intervention to improve NSW primary schools' implementation of the SunSmart Program. Health Promot J Austr 2018; 30:267-271. [PMID: 30972900 DOI: 10.1002/hpja.27] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2017] [Accepted: 12/04/2017] [Indexed: 11/05/2022] Open
Abstract
ISSUE ADDRESSED The SunSmart Policy Support and Intervention Study (SSPSIS) (ACTRN12614000926639) investigated the feasibility of improving schools' implementation of the SunSmart Program, which is a resource for primary school communities to support their development of a comprehensive sun protection policy. METHODS A cluster randomised controlled trial (RCT) was used to evaluate the SSPSIS, which was conducted in NSW SunSmart schools (n = 20). Objective measurements of students' sun-safe hat-wearing behaviours and sunscreen application, and teachers' role-modelling behaviours, were collected for baseline, post-test and follow-up data. Interviews with school community stakeholders, including students (n = 103), parents (n = 31), teachers (n = 11) and executive staff (n = 4), were conducted to inform the intervention design, which was implemented following baseline data collection. RESULTS The results of baseline observations and interviews have been published previously. The intervention design aimed to combat negative perceptions of hat-wearing policy and create a trigger for sunscreen application by rewarding students practising these sun protection behaviours with play-based incentives. Although this intervention had no significant effect on the wearing of sun-safe hats among students or teachers, it did have a large effect on the consumption of sunscreen. CONCLUSIONS Associating sunscreen and play-based incentives can create an effective trigger for students' sunscreen application behaviours. However, further evidence is needed to investigate how students' and teacher role models' hat-wearing behaviours could be increased. SO WHAT?: While combining a play-based incentive with a trigger for behaviour can promptly increase students' sunscreen application, it was unable to increase students' or teacher role models' hat-wearing behaviours.
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Affiliation(s)
- Bradley Wright
- School of Teacher Education, Charles Sturt University, Bathurst, NSW, Australia
| | - Matthew Winslade
- School of Teacher Education, Charles Sturt University, Bathurst, NSW, Australia
| | - Dean Dudley
- School of Education, Macquarie University, Sydney, NSW, Australia
| | - Wayne Cotton
- Faculty of Education and Social Work, University of Sydney, Camperdown, NSW, Australia
| | - Alexandra Hamer
- Cancer Council New South Wales, Woolloomooloo, NSW, Australia
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Savoye I, Olsen CM, Whiteman DC, Bijon A, Wald L, Dartois L, Clavel-Chapelon F, Boutron-Ruault MC, Kvaskoff M. Patterns of Ultraviolet Radiation Exposure and Skin Cancer Risk: the E3N-SunExp Study. J Epidemiol 2018; 28:27-33. [PMID: 29176271 PMCID: PMC5742376 DOI: 10.2188/jea.je20160166] [Citation(s) in RCA: 68] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2016] [Accepted: 12/23/2016] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND While ultraviolet (UV) radiation exposure is a recognized risk factor for skin cancer, associations are complex and few studies have allowed a direct comparison of exposure profiles associated with cutaneous melanoma, basal-cell carcinoma (BCC), and squamous-cell carcinoma (SCC) within a single population. METHODS We examined associations between UV exposures and skin cancer risk in a nested case-control study within E3N, a prospective cohort of 98,995 French women born in 1925-1950. In 2008, a lifetime UV exposure questionnaire was sent to all reported skin cancer cases and three controls per case, which were matched on age, county of birth, and education. Analyses were performed using conditional logistic regression and included 366 melanoma cases, 1,027 BCC cases, 165 SCC cases, and 3,647 controls. RESULTS A history of severe sunburns <25 years was associated with increased risks of all skin cancers (melanoma: OR 2.7; BCC: OR 1.7; SCC: OR 2.0 for ≥6 sunburns vs. none), while sunburns ≥25 years were associated with BCC and SCC only. While high-sun protection factor sunscreen use before age 25 was associated with lower BCC risk (Ptrend = 0.02), use since age 25 and reapplication of sunscreen were associated with higher risks of all three types of skin cancer. There were positive linear associations between total UV score and risks of BCC (Ptrend = 0.01) and SCC (Ptrend = 0.09), but not melanoma. While recreational UV score was strongly associated with BCC, total and residential UV scores were more strongly associated with SCC. CONCLUSIONS Melanoma, BCC, and SCC are associated with different sun exposure profiles in women.
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Affiliation(s)
- Isabelle Savoye
- CESP, Fac. de médecine - Univ. Paris-Sud, Fac. de médecine - UVSQ, INSERM, Université Paris-Saclay, Villejuif, France
- Gustave Roussy, Villejuif, France
| | - Catherine M Olsen
- Population Health Department, QIMR Berghofer Medical Research Institute, Herston, Queensland, Australia
- School of Public Health, the University of Queensland, Herston, Queensland, Australia
| | - David C Whiteman
- Population Health Department, QIMR Berghofer Medical Research Institute, Herston, Queensland, Australia
- School of Public Health, the University of Queensland, Herston, Queensland, Australia
| | - Anne Bijon
- CESP, Fac. de médecine - Univ. Paris-Sud, Fac. de médecine - UVSQ, INSERM, Université Paris-Saclay, Villejuif, France
- Gustave Roussy, Villejuif, France
| | - Lucien Wald
- MINES ParisTech, PSL-Research University, O.I.E. – Centre Observation, Impacts, Energy, Sophia Antipolis, France
| | - Laureen Dartois
- CESP, Fac. de médecine - Univ. Paris-Sud, Fac. de médecine - UVSQ, INSERM, Université Paris-Saclay, Villejuif, France
- Gustave Roussy, Villejuif, France
| | - Françoise Clavel-Chapelon
- CESP, Fac. de médecine - Univ. Paris-Sud, Fac. de médecine - UVSQ, INSERM, Université Paris-Saclay, Villejuif, France
- Gustave Roussy, Villejuif, France
| | - Marie-Christine Boutron-Ruault
- CESP, Fac. de médecine - Univ. Paris-Sud, Fac. de médecine - UVSQ, INSERM, Université Paris-Saclay, Villejuif, France
- Gustave Roussy, Villejuif, France
| | - Marina Kvaskoff
- CESP, Fac. de médecine - Univ. Paris-Sud, Fac. de médecine - UVSQ, INSERM, Université Paris-Saclay, Villejuif, France
- Gustave Roussy, Villejuif, France
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58
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Colebatch AJ, Scolyer RA. Trajectories of premalignancy during the journey from melanocyte to melanoma. Pathology 2018; 50:16-23. [PMID: 29132722 DOI: 10.1016/j.pathol.2017.09.002] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2017] [Accepted: 09/11/2017] [Indexed: 11/16/2022]
Abstract
A stepwise progression from melanocytic precursors to cutaneous melanoma is a well-established model, based on decades of careful observation and morphological analysis. The steps identified are benign melanocytic naevus, dysplastic naevus, 'radial growth phase' melanoma (including melanoma in situ) and 'vertical growth phase' melanoma (also termed tumourigenic melanoma). Recent genomic data have refined the understanding of the steps of melanoma development and their relationship to one another. These data support the existence of dysplastic naevi as distinct lesions; suggest the importance of clonal dynamics in the precursor steps of melanoma; and confirm the carcinogenic role of ultraviolet radiation throughout early melanoma development and progression. In this review, the steps of melanoma development and progression are summarised and discussed in the context of recent genomic studies. This new understanding of melanoma pathogenesis that has been facilitated through careful correlation of morphological and molecular features will allow the identification and development of robust biomarkers to assist in more accurate diagnosis and prognostication of melanocytic tumours.
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Affiliation(s)
- Andrew J Colebatch
- Tissue Pathology and Diagnostic Oncology, Royal Prince Alfred Hospital, Camperdown, Australia; Melanoma Institute of Australia, The University of Sydney, North Sydney, Australia; Discipline of Pathology, Sydney Medical School, The University of Sydney, Sydney, NSW, Australia.
| | - Richard A Scolyer
- Tissue Pathology and Diagnostic Oncology, Royal Prince Alfred Hospital, Camperdown, Australia; Melanoma Institute of Australia, The University of Sydney, North Sydney, Australia; Discipline of Pathology, Sydney Medical School, The University of Sydney, Sydney, NSW, Australia
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59
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Krzywon A, Widel M, Fujarewicz K, Skonieczna M, Rzeszowska-Wolny J. Modulation by neighboring cells of the responses and fate of melanoma cells irradiated with UVA. JOURNAL OF PHOTOCHEMISTRY AND PHOTOBIOLOGY B-BIOLOGY 2017; 178:505-511. [PMID: 29241122 DOI: 10.1016/j.jphotobiol.2017.12.012] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/11/2017] [Revised: 12/07/2017] [Accepted: 12/08/2017] [Indexed: 02/03/2023]
Abstract
UVA radiation, which accounts for about 95% of the solar spectrum, contributes to and may be the etiological factor of skin cancers of which malignant melanoma is the most aggressive. UVA causes oxidative stress in various types of cells in the skin, keratinocyte, melanocytes, and fibroblasts, which is responsible for its cytotoxic effect. Here we used a transwell system to explore how the responses of melanoma cells to a low dose of UVA (20kJ/m2, ~10% of the minimal erythema dose) are influenced by neighboring co-cultured melanoma cells or fibroblasts. This dose had a low toxicity for melanoma cells, but after irradiation, co-culture with non-irradiated melanoma cells caused a strong decline in their viability and an increased frequency of apoptosis, whereas co-culture with fibroblast exerted a protective effect on irradiated melanoma cells. At the same time, the presence of non-irradiated cells, especially fibroblasts, decreased the level of UVA-induced reactive oxygen and nitrogen species. Interleukins efficiently produced by fibroblasts seem to be main players in these effects. Our studies reveal that coexistence of fibroblasts with melanoma cells may strongly modulate the direct action and may change bystander effects exerted by UVA light. Similar modulation of the effect of UVA on melanoma cells in vivo by bystander-like signaling from neighboring cells would have consequences for the development of malignant melanoma.
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Affiliation(s)
- Aleksandra Krzywon
- Biosystems Group, Institute of Automatic Control, Faculty of Automatics, Electronics and Informatics, Silesian University of Technology, 16 Akademicka Street, 44-100 Gliwice, Poland
| | - Maria Widel
- Biosystems Group, Institute of Automatic Control, Faculty of Automatics, Electronics and Informatics, Silesian University of Technology, 16 Akademicka Street, 44-100 Gliwice, Poland.
| | - Krzysztof Fujarewicz
- Biosystems Group, Institute of Automatic Control, Faculty of Automatics, Electronics and Informatics, Silesian University of Technology, 16 Akademicka Street, 44-100 Gliwice, Poland
| | - Magdalena Skonieczna
- Biosystems Group, Institute of Automatic Control, Faculty of Automatics, Electronics and Informatics, Silesian University of Technology, 16 Akademicka Street, 44-100 Gliwice, Poland
| | - Joanna Rzeszowska-Wolny
- Biosystems Group, Institute of Automatic Control, Faculty of Automatics, Electronics and Informatics, Silesian University of Technology, 16 Akademicka Street, 44-100 Gliwice, Poland
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60
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Wu YP, Mays D, Kohlmann W, Tercyak KP. Pediatric Predispositional Genetic Risk Communication: Potential Utility for Prevention and Control of Melanoma Risk as an Exemplar. J Genet Couns 2017; 26:887-893. [PMID: 28547663 PMCID: PMC5702278 DOI: 10.1007/s10897-017-0105-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2016] [Accepted: 04/25/2017] [Indexed: 12/20/2022]
Abstract
Predispositional genetic testing among minor children is intensely debated due to the potential benefits and harms of providing this type of genetic information to children and their families. Existing guidelines on pediatric genetic testing state that predispositional testing could be appropriate for minors if preventive services exist that mitigate children's risk for or severity of the health condition in question. We use the example of hereditary melanoma to illustrate the rationale for and potential application of genetic risk communication for an adult-onset cancer to a pediatric population where childhood behaviors may reduce risk of disease later in life. We draw from the adult melanoma genetic risk communication and pediatric health behavior change literatures to suggest ways in which genetic test reporting and complementary education could be delivered to children who carry a hereditary risk for melanoma and their families in order to foster children's engagement in melanoma preventive behaviors. Genetic discoveries will continue to yield new opportunities to provide predispositional genetic risk information to unaffected individuals, including children, and could be delivered within programs that provide personalized and translational approaches to cancer prevention.
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Affiliation(s)
- Yelena P Wu
- Division of Public Health, Department of Family & Preventive Medicine, University of Utah, 375 Chipeta Way, Suite A, Salt Lake City, UT, 84108, USA.
- Huntsman Cancer Institute, Salt Lake City, UT, USA.
| | - Darren Mays
- Lombardi Comprehensive Cancer Center, Georgetown University, Washington, D.C, USA
| | | | - Kenneth P Tercyak
- Lombardi Comprehensive Cancer Center, Georgetown University, Washington, D.C, USA
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61
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Mouse models of UV-induced melanoma: genetics, pathology, and clinical relevance. J Transl Med 2017; 97:698-705. [PMID: 28092363 PMCID: PMC5514606 DOI: 10.1038/labinvest.2016.155] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2016] [Revised: 12/14/2016] [Accepted: 12/15/2016] [Indexed: 02/05/2023] Open
Abstract
Melanocytes, a neural crest cell derivative, produce pigment to protect keratinocytes from ultraviolet radiation (UVR). Although melanocytic lesions such as nevi and cutaneous malignant melanomas are known to be associated with sun exposure, the role of UVR in oncogenesis is complex and has yet to be clearly elucidated. UVR appears to have a direct mutational role in inducing or promoting melanoma formation as well as an indirect role through microenvironmental changes. Recent advances in the modeling of human melanoma in animals have built platforms upon which prospective studies can begin to investigate these questions. This review will focus exclusively on genetically engineered mouse models of UVR-induced melanoma. The role that UVR has in mouse models depends on multiple factors, including the waveband, timing, and dose of UVR, as well as the nature of the oncogenic agent(s) driving melanomagenesis in the model. Work in the field has examined the role of neonatal and adult UVR, interactions between UVR and common melanoma oncogenes, the role of sunscreen in preventing melanoma, and the effect of UVR on immune function within the skin. Here we describe relevant mouse models and discuss how these models can best be translated to the study of human skin and cutaneous melanoma.
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62
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Vanos JK, McKercher GR, Naughton K, Lochbaum M. Schoolyard Shade and Sun Exposure: Assessment of Personal Monitoring During Children's Physical Activity. Photochem Photobiol 2017; 93:1123-1132. [PMID: 28097673 DOI: 10.1111/php.12721] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2016] [Accepted: 11/29/2016] [Indexed: 11/29/2022]
Abstract
Childhood exposure to ultraviolet radiation (UVR) is a major risk factor for the development of melanoma later in life. However, it is challenging to accurately determine personal outdoor exposure to UVR, specifically erythemally weighted UVR (UVEry ), due to technological constraints, variable time-activity patterns, and the influence of outdoor environmental design. To address this challenge, this study utilized mobile and stationary techniques to examine the UVEry exposures of 14 children in a schoolyard in Lubbock, TX, in spring 2016. The aims of the study were to examine the influence of artificial shade on personal UVEry exposures and to assess full sun exposure ratios (ERs) within the same playground microenvironment. On average, personal wrist dosimeters worn during play in the sun measured 18% of the total onsite UVEry measured by a stationary UV pyranometer. Shade was found to significantly reduce the personal UVEry exposures by 55%, UVB280-315 nm exposures by 91%, and the overall solar radiation by 84%. Substantial benefits can be garnered through focused design of children's recreational space to utilize shade-both natural and artificial-to reduce UVR exposures during play, and to extend safe outdoor stays. Finally, although the wrist is a practical location for a dosimeter, it often underestimates full exposures, particularly during physical activity.
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Affiliation(s)
- Jennifer K Vanos
- Atmospheric Science Research Group, Department of Geosciences, Texas Tech University, Lubbock, TX.,Climate, Atmospheric Science, and Physical Oceanography, Scripps Institution of Oceanography, University of California San Diego, La Jolla, CA
| | - Grant R McKercher
- Atmospheric Science Research Group, Department of Geosciences, Texas Tech University, Lubbock, TX
| | - Kylie Naughton
- Climate Science Center, Texas Tech University, Lubbock, TX
| | - Marc Lochbaum
- Exercise & Sport Psychology, Texas Tech University, Lubbock, TX.,KIHU - Research Institute for Olympic Sports, Jyväskylä, Finland
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63
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RODRÍGUEZ-GAMBETTA P, MOSCOSO-PORRAS M, TAYPE-RONDAN A. Factors associated with regular sunscreen use by medical students of a Peruvian university. JOURNAL OF PREVENTIVE MEDICINE AND HYGIENE 2016; 57:E172-E177. [PMID: 27980382 PMCID: PMC5139613] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
INTRODUCTION Use of sunscreen is encouraged to reduce the risk of skin pathologies caused by radiation. It is important to acknowledge the associated factors that promote or hinder sunscreen use in young populations as to design better prevention policies. OBJECTIVE To determine the factors associated with regular sunscreen use among first year medical students from a Peruvian university. MATERIALS AND METHODS A cross-sectional study was performed. Our population was first-year medical students from a Peruvian university. We administrated an electronic survey to evaluate socio-demographic data, as well as student knowledge, attitudes, and practices regarding photo-protection. We used ordinal logistic regression to analyze the factors associated with sunscreen use. RESULTS Of 420 first-year students, 299 completed our survey. We found that 53.5% of the participants were less than 18 years old, 63.2% were female, 9.3% (females more than males) responded that a sunburn was worth it to look tan, and 38.1% always or almost always used sunscreen during the summer. Factors associated with sunscreen use in the ordered logistic adjusted regression were male sex (OR = 0.50, IC95% = 0.34-0.86), participation in photo-protection workshops within the last year (OR = 2.40, IC95% = 1.28-4.37), and having somebody to remind them the use of sunscreen during the last three months (OR = 3.80, IC95% = 1.28-11.20). CONCLUSIONS In our sample, a higher sunscreen use was more often observed among female participants, those who attended skin protection workshops, and those reminded to use sunscreen. This highlights the importance of educational and reminder activities in the adoption of protective habits, such as sunscreen use.
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Affiliation(s)
| | - M.G. MOSCOSO-PORRAS
- CRONICAS Center of Excellence for Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - A. TAYPE-RONDAN
- CRONICAS Center of Excellence for Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, Peru,Correspondence: Alvaro Taype-Rondan, CRONICAS Center of Excellence for Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, Peru, Avenida Armendáriz 497, Miraflores, Lima 18, Peru - Tel. +51 970001517 - E-mail:
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Wu YP, Aspinwall LG, Conn BM, Stump T, Grahmann B, Leachman SA. A systematic review of interventions to improve adherence to melanoma preventive behaviors for individuals at elevated risk. Prev Med 2016; 88:153-67. [PMID: 27090434 PMCID: PMC4902721 DOI: 10.1016/j.ypmed.2016.04.010] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2016] [Revised: 04/07/2016] [Accepted: 04/12/2016] [Indexed: 12/20/2022]
Abstract
BACKGROUND AND OBJECTIVES To examine the effectiveness of behavioral interventions for melanoma prevention targeted to individuals at elevated risk due to personal and/or family history. METHODS Through literature searches in 5 search databases (through July 2014), 20 articles describing 14 unique interventions focused on melanoma prevention among individuals at elevated risk for the disease were identified. Interventions targeting only patients undergoing active treatment for melanoma were excluded. RESULTS The average study quality was moderate. The majority of interventions (6 out of 9, 66% of studies) led to improvements in one or more photoprotective behaviors, particularly for improvements in use of protective clothing (3 out of 5, 60% of studies), and frequency and/or thoroughness of skin self-examinations (9 out of 12, 75%). Fewer interventions (5 out of 14, 36%) targeted uptake of total body skin examinations (60% led to improvements). Also, fewer interventions targeted all three preventive behaviors (5 out of 14, 36%). CONCLUSIONS Findings suggest that future interventions should aim to improve adherence across multiple preventive behaviors, over a longer time period (past 8months post-intervention), and target high-risk children. Studies should include adequate sample sizes to investigate moderators and mediators of intervention effectiveness. Interventions may be strengthened by new techniques, such as incorporating family members (e.g., to improve thoroughness of skin self-examinations) and eHealth technology.
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Affiliation(s)
- Yelena P Wu
- Division of Public Health, Department of Family and Preventive Medicine, University of Utah, USA; Huntsman Cancer Institute, USA.
| | - Lisa G Aspinwall
- Huntsman Cancer Institute, USA; Department of Psychology, University of Utah, USA
| | - Bridgid M Conn
- Department of Pediatrics, Division of Adolescent and Young Adult Medicine, Children's Hospital Los Angeles, USA
| | - Tammy Stump
- Department of Psychology, University of Utah, USA
| | - Bridget Grahmann
- Division of Public Health, Department of Family and Preventive Medicine, University of Utah, USA
| | - Sancy A Leachman
- Huntsman Cancer Institute, USA; Department of Dermatology, Oregon Health & Science University, USA
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Hansen L, Tjønneland A, Køster B, Brot C, Andersen R, Lundqvist M, Christensen J, Olsen A. Sun Exposure Guidelines and Serum Vitamin D Status in Denmark: The StatusD Study. Nutrients 2016; 8:nu8050266. [PMID: 27164133 PMCID: PMC4882679 DOI: 10.3390/nu8050266] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2016] [Revised: 04/14/2016] [Accepted: 05/02/2016] [Indexed: 12/29/2022] Open
Abstract
Little is known on how vitamin D status is affected by adherence to UVB-limiting sun exposure guidelines. Our aim was to investigate the relationship between adherence to the Danish sun exposure guidelines and vitamin D status. In total, 3194 Danes (2625 adults, 569 children) were recruited among the general population, and more than 92% had blood samples taken both autumn and spring. Using linear regression, we associated serum vitamin D concentrations to questionnaire responses on: seeking shade, wearing a sunhat, wearing protective clothing or using sunscreen. The odds ratio (OR) of either low (<25 or 50 nmol/L) or adequate/high (≥50 nmol/L) vitamin D status was examined using logistic regression. For adults, those who always sought shade or wore protective clothing compared to those who did not had lower levels of vitamin D (autumn concentrations for shade: 7.2 nmol/L lower (−11.0–−3.6 nmol/L); for protective clothing: 9.9 nmol/L lower (−13.6–−6.2 nmol/L). Adherence to all four guidelines was also associated with lower vitamin D concentrations (autumn: 9.7 nmol/L lower (−14.3–−5.1 nmol/L). Use of sunscreen was associated with adequate vitamin D status, as those who always sought shade compared to those who did not had an OR (95% CI) of 1.68 (1.25–2.35) of having ≥50 nmol/L during both spring and autumn. No associations were found with wearing a sunhat, and there were no clear associations for children. In conclusion, adherence to the sun exposure guidelines on shade and protective clothing was associated with lower vitamin D status among Danish adults, but not children.
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Affiliation(s)
- Louise Hansen
- Unit of Diet, Genes and Environment, Danish Cancer Society Research Center, Copenhagen DK-2100, Denmark.
| | - Anne Tjønneland
- Unit of Diet, Genes and Environment, Danish Cancer Society Research Center, Copenhagen DK-2100, Denmark.
| | - Brian Køster
- Department of Prevention and Information, Danish Cancer Society, Copenhagen DK-2100, Denmark.
| | - Christine Brot
- Danish Health Authority, Health Promotion, Copenhagen DK-2300, Denmark.
| | - Rikke Andersen
- Technical University of Denmark, National Food Institute, Division for Diet, Disease Prevention and Toxicology, Research Group for Risk-Benefit, Søborg DK-2860, Denmark.
| | - Marika Lundqvist
- Statens Serum Institute, Department of Congenital Disorders, Danish Centre for Neonatal Screening, Copenhagen DK-2300, Denmark.
| | - Jane Christensen
- Unit of Statistics, Bioinformatics and Registry, Danish Cancer Society Research Center, Copenhagen DK-2100, Denmark.
| | - Anja Olsen
- Unit of Diet, Genes and Environment, Danish Cancer Society Research Center, Copenhagen DK-2100, Denmark.
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Recognizing melanoma: Diagnosis and treatment options. Nurse Pract 2016; 41:24-9; quiz 29-30. [PMID: 26974049 DOI: 10.1097/01.npr.0000481508.24736.81] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Melanoma is a malignant tumor that is usually cutaneous in origin and is associated with significant morbidity and mortality. As one of the most common cancers seen in young adults, melanoma represents a major public health concern in terms of years of lost productivity.
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Zhou G, Zhang L, Knoll N, Schwarzer R. Facilitating Sunscreen Use Among Chinese Young Adults: Less-Motivated Persons Benefit from a Planning Intervention. Int J Behav Med 2016; 22:443-51. [PMID: 25515914 DOI: 10.1007/s12529-014-9458-7] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND The effect of a self-regulatory intervention with its focus on planning sunscreen use is evaluated in comparison to a standard educational condition. PURPOSE This paper studied whether planning mediates between the experimental conditions and the behavioral outcome. Further, it is examined who benefits more: already motivated or unmotivated individuals. METHOD College students (N = 253) were randomly assigned to two groups: a self-regulatory and a standard-care condition. Sunscreen use, intention to use sunscreen, and planning were assessed at two points in time, 1 month apart. RESULTS The self-regulatory intervention improved planning to use sunscreen but not the behavior directly. Planning emerged as the mediator between conditions and later sunscreen use, controlling for baseline behavior. Moreover, participants who were less motivated benefited more from the intervention. CONCLUSIONS Although it is generally assumed that planning interventions are best designed for already motivated persons, the present findings suggest that less prepared individuals might have more to gain from a brief self-regulatory intervention.
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Affiliation(s)
- Guangyu Zhou
- Department of Educational Science and Psychology, Freie Universität Berlin, Berlin, Germany,
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Wu YP, Aspinwall LG, Michaelis TC, Stump T, Kohlmann WG, Leachman SA. Discussion of photoprotection, screening, and risk behaviors with children and grandchildren after melanoma genetic testing. J Community Genet 2016; 7:21-31. [PMID: 26099287 PMCID: PMC4715817 DOI: 10.1007/s12687-015-0243-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2015] [Accepted: 06/04/2015] [Indexed: 12/20/2022] Open
Abstract
The purpose of the current study was to examine changes in frequency of discussion about melanoma preventive behaviors among adults who received melanoma genetic test reporting and counseling and their children and grandchildren, correspondence of frequency of discussion with intentions, and content of discussions. Participants received CDKN2A/p16 testing and counseling (N = 24, 46 % p16-positive). Discussions about preventive behaviors were assessed before testing and 1 and 6 months post-testing. Intentions to discuss preventive behaviors and perceived preparedness to discuss risk were assessed post-testing. Open-ended questions assessed content of reported discussions. Discussion of preventive behaviors declined following test reporting, with more rapid decline reported by noncarriers. There was a large gap between the percentage of participants who intended to discuss preventive behaviors and who then reported discussions 1 and 6 months after counseling. Participants felt prepared to discuss melanoma risk but also suggested resources to facilitate discussions. Genetic test reporting and counseling alone did not sustain discussions about preventive behaviors for a hereditary cancer with children and grandchildren. The gap between intentions to have discussions and reported discussions has implications for augmentation of counseling to support at-risk families' discussions about preventive behaviors.
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Affiliation(s)
- Yelena P Wu
- Division of Public Health, Department of Family and Preventive Medicine, University of Utah, 375 Chipeta Way, Suite A, Salt Lake City, UT, 84108, USA.
- Huntsman Cancer Institute, 2000 Circle of Hope Drive, Salt Lake City, UT, 84112, USA.
| | - Lisa G Aspinwall
- Department of Psychology, University of Utah, 380 South 1530 East, Salt Lake City, UT, 84112, USA
| | - Timothy C Michaelis
- School of Medicine, University of Utah, 30 North 1900 East, Salt Lake City, UT, 84132, USA
| | - Tammy Stump
- Department of Psychology, University of Utah, 380 South 1530 East, Salt Lake City, UT, 84112, USA
| | - Wendy G Kohlmann
- Huntsman Cancer Institute, 2000 Circle of Hope Drive, Salt Lake City, UT, 84112, USA
| | - Sancy A Leachman
- Department of Dermatology, Oregon Health and Science University, 3303 Southwest Bond Avenue, Portland, OR, 97239, USA
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Greinert R, de Vries E, Erdmann F, Espina C, Auvinen A, Kesminiene A, Schüz J. European Code against Cancer 4th Edition: Ultraviolet radiation and cancer. Cancer Epidemiol 2015; 39 Suppl 1:S75-83. [PMID: 26096748 DOI: 10.1016/j.canep.2014.12.014] [Citation(s) in RCA: 68] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2014] [Revised: 10/10/2014] [Accepted: 12/14/2014] [Indexed: 12/31/2022]
Abstract
Ultraviolet radiation (UVR) is part of the electromagnetic spectrum emitted naturally from the sun or from artificial sources such as tanning devices. Acute skin reactions induced by UVR exposure are erythema (skin reddening), or sunburn, and the acquisition of a suntan triggered by UVR-induced DNA damage. UVR exposure is the main cause of skin cancer, including cutaneous malignant melanoma, basal-cell carcinoma, and squamous-cell carcinoma. Skin cancer is the most common cancer in fair-skinned populations, and its incidence has increased steeply over recent decades. According to estimates for 2012, about 100,000 new cases of cutaneous melanoma and about 22,000 deaths from it occurred in Europe. The main mechanisms by which UVR causes cancer are well understood. Exposure during childhood appears to be particularly harmful. Exposure to UVR is a risk factor modifiable by individuals' behaviour. Excessive exposure from natural sources can be avoided by seeking shade when the sun is strongest, by wearing appropriate clothing, and by appropriately applying sunscreens if direct sunlight is unavoidable. Exposure from artificial sources can be completely avoided by not using sunbeds. Beneficial effects of sun or UVR exposure, such as for vitamin D production, can be fully achieved while still avoiding too much sun exposure and the use of sunbeds. Taking all the scientific evidence together, the recommendation of the 4th edition of the European Code Against Cancer for ultraviolet radiation is: "Avoid too much sun, especially for children. Use sun protection. Do not use sunbeds."
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Affiliation(s)
- Rüdiger Greinert
- Center of Dermatology, Department of Molecular Cell Biology, Elbekliniken Stade/Buxtehude, Am Krankenhaus 1, D-21614 Buxtehude, Germany
| | - Esther de Vries
- Department of Public Health, Erasmus MC/Section of Cancer Information, Gravendijkwal 230, 3015 CE Rotterdam, The Netherlands
| | - Friederike Erdmann
- International Agency for Research on Cancer (IARC), 150 Cours Albert Thomas, 69372 Lyon, France
| | - Carolina Espina
- International Agency for Research on Cancer (IARC), 150 Cours Albert Thomas, 69372 Lyon, France
| | - Anssi Auvinen
- School of Health Sciences, University of Tampere, FI-33014 Tampere, Finland; STUK - Radiation and Nuclear Safety Authority, Research and Environmental Surveillance, Helsinki, Finland
| | - Ausrele Kesminiene
- International Agency for Research on Cancer (IARC), 150 Cours Albert Thomas, 69372 Lyon, France
| | - Joachim Schüz
- International Agency for Research on Cancer (IARC), 150 Cours Albert Thomas, 69372 Lyon, France.
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Glenn BA, Lin T, Chang LC, Okada A, Wong WK, Glanz K, Bastani R. Sun protection practices and sun exposure among children with a parental history of melanoma. Cancer Epidemiol Biomarkers Prev 2015; 24:169-77. [PMID: 25587110 DOI: 10.1158/1055-9965.epi-14-0650] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND First-degree relatives of melanoma survivors have a substantially higher lifetime risk for melanoma than individuals with no family history. Exposure to ultraviolet radiation (UVR) is the primary modifiable risk factor for the disease. Reducing UV exposure through sun protection may be particularly important for children with a parental history of melanoma. Nonetheless, limited prior research has investigated sun protection practices and sun exposure among these children. METHODS The California Cancer Registry was used to identify melanoma survivors eligible to participate in a survey to assess their children's sun protection practices and sun exposure. The survey was administered by mail, telephone, or web to Latino and non-Latino white melanoma survivors with at least one child (0-17 years; N = 324). RESULTS Sun exposure was high and the rate of sunburn was equivalent to or higher than estimates from average-risk populations. Use of sun protection was suboptimal. Latino children were less likely to wear sunscreen and hats and more likely to wear sunglasses, although these differences disappeared in adjusted analyses. Increasing age of the child was associated with lower sun protection and higher risk for sunburn, whereas higher objective risk for melanoma predicted improved sun protection and a higher risk for sunburns. Perception of high barriers to sun protection was the strongest modifiable correlate of sun protection. CONCLUSIONS Interventions to improve sun protection and reduce sun exposure and sunburns in high-risk children are needed. IMPACT Intervening in high-risk populations may help reduce the burden of melanoma in the United States.
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Affiliation(s)
- Beth A Glenn
- UCLA Fielding School of Public Health and Jonsson Comprehensive Cancer Center, Los Angeles, California.
| | - Tiffany Lin
- UCLA Fielding School of Public Health and Jonsson Comprehensive Cancer Center, Los Angeles, California
| | - L Cindy Chang
- UCLA Fielding School of Public Health and Jonsson Comprehensive Cancer Center, Los Angeles, California
| | - Ashley Okada
- UCLA Fielding School of Public Health and Jonsson Comprehensive Cancer Center, Los Angeles, California
| | - Weng Kee Wong
- UCLA Fielding School of Public Health and Jonsson Comprehensive Cancer Center, Los Angeles, California
| | - Karen Glanz
- Perelman School of Medicine and School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Roshan Bastani
- UCLA Fielding School of Public Health and Jonsson Comprehensive Cancer Center, Los Angeles, California
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Vitamin D Status in South Africa and Tuberculosis. Lung 2015; 193:975-84. [DOI: 10.1007/s00408-015-9789-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2015] [Accepted: 08/19/2015] [Indexed: 12/11/2022]
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Perez D, Kite J, Dunlop SM, Cust AE, Goumas C, Cotter T, Walsberger SC, Dessaix A, Bauman A. Exposure to the 'Dark Side of Tanning' skin cancer prevention mass media campaign and its association with tanning attitudes in New South Wales, Australia. HEALTH EDUCATION RESEARCH 2015; 30:336-346. [PMID: 25697580 DOI: 10.1093/her/cyv002] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Melanoma is the most common cancer among 15- to 29-year-olds in Australia, with rates increasing with age. The 'Dark Side of Tanning' (DSOT) mass media campaign was developed in 2007 to influence attitudes related to tanning. This study aimed to assess recall and impact of the DSOT campaign. Data were collected using online surveys of 13- to 44-year-olds living in New South Wales in the summer months of 2007-2010 (n = 7490). Regression models were used to determine predictors of recall of DSOT and to investigate associations between exposure to the campaign and tanning attitudes. The campaign achieved consistently high recall (unprompted recall 42-53% during campaign periods; prompted recall 76-84%). Those who recalled DSOT advertisements had a higher likelihood of reporting negative tanning attitudes compared with those who reported no recall, after adjusting for other factors (odds ratio [OR] 1.13, 95% confidence interval [CI] 1.01-1.27 for unprompted recall; OR 1.19, 95% CI 1.03-1.36 for prompted recall). Being interviewed in later campaign years was also a significant predictor of negative tanning attitudes (e.g. fourth year of campaign versus first year: OR 1.24, 95% CI 1.01-1.53). These results suggest that mass media campaigns have potential to influence tanning-related attitudes and could play an important role in skin cancer prevention.
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Affiliation(s)
- Donna Perez
- Cancer Institute NSW - Cancer Screening and Prevention, Sydney, NSW, Australia, University of Sydney - School of Public Health, Sydney, NSW, Australia, Victorian Comprehensive Cancer Center, Melbourne, VIC, Australia and Cancer Council NSW, Sydney, NSW, Australia
| | - James Kite
- Cancer Institute NSW - Cancer Screening and Prevention, Sydney, NSW, Australia, University of Sydney - School of Public Health, Sydney, NSW, Australia, Victorian Comprehensive Cancer Center, Melbourne, VIC, Australia and Cancer Council NSW, Sydney, NSW, Australia
| | - Sally M Dunlop
- Cancer Institute NSW - Cancer Screening and Prevention, Sydney, NSW, Australia, University of Sydney - School of Public Health, Sydney, NSW, Australia, Victorian Comprehensive Cancer Center, Melbourne, VIC, Australia and Cancer Council NSW, Sydney, NSW, Australia
| | - Anne E Cust
- Cancer Institute NSW - Cancer Screening and Prevention, Sydney, NSW, Australia, University of Sydney - School of Public Health, Sydney, NSW, Australia, Victorian Comprehensive Cancer Center, Melbourne, VIC, Australia and Cancer Council NSW, Sydney, NSW, Australia
| | - Chris Goumas
- Cancer Institute NSW - Cancer Screening and Prevention, Sydney, NSW, Australia, University of Sydney - School of Public Health, Sydney, NSW, Australia, Victorian Comprehensive Cancer Center, Melbourne, VIC, Australia and Cancer Council NSW, Sydney, NSW, Australia
| | - Trish Cotter
- Cancer Institute NSW - Cancer Screening and Prevention, Sydney, NSW, Australia, University of Sydney - School of Public Health, Sydney, NSW, Australia, Victorian Comprehensive Cancer Center, Melbourne, VIC, Australia and Cancer Council NSW, Sydney, NSW, Australia
| | - Scott C Walsberger
- Cancer Institute NSW - Cancer Screening and Prevention, Sydney, NSW, Australia, University of Sydney - School of Public Health, Sydney, NSW, Australia, Victorian Comprehensive Cancer Center, Melbourne, VIC, Australia and Cancer Council NSW, Sydney, NSW, Australia
| | - Anita Dessaix
- Cancer Institute NSW - Cancer Screening and Prevention, Sydney, NSW, Australia, University of Sydney - School of Public Health, Sydney, NSW, Australia, Victorian Comprehensive Cancer Center, Melbourne, VIC, Australia and Cancer Council NSW, Sydney, NSW, Australia
| | - Adrian Bauman
- Cancer Institute NSW - Cancer Screening and Prevention, Sydney, NSW, Australia, University of Sydney - School of Public Health, Sydney, NSW, Australia, Victorian Comprehensive Cancer Center, Melbourne, VIC, Australia and Cancer Council NSW, Sydney, NSW, Australia
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Oldenburg M, Harth V, Manuwald U. Hospitalization due to cancer among German seafarers. Am J Ind Med 2015; 58:456-63. [PMID: 25712579 DOI: 10.1002/ajim.22423] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/15/2014] [Indexed: 11/05/2022]
Abstract
OBJECTIVES To evaluate the relative risk of cancer among male German seafarers employed on German vessels in respect of various shipboard ranks and types of vessel. METHODS The seafarers' cancer discharge diagnoses from hospital were compared with those discharge diagnoses from the German general population and expressed as a standardized hospitalization ratio (SHR). RESULTS The examined seafarers (on average 23,436 per year) showed a higher SHR for malignant neoplasms at all sites, in decreasing order for leukemia, non-Hodgkin lymphoma (NHL), respiratory cancer, and non-melanoma skin cancer. Seafarers employed on tankers showed a considerably elevated SHR for malignant neoplasms at all sites, which was mainly attributable to their high SHR for leukemia and respiratory cancer. CONCLUSIONS Seafaring occupations pose an elevated risk of certain cancers. Further studies are required to evaluate to what extent occupational exposure to carcinogenic substances and lifestyle-related unhealthy behaviours contribute to the increased risk of cancer in seafarers.
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Affiliation(s)
- Marcus Oldenburg
- Institute for Occupational and Maritime Medicine; ZfAM; University Medical Center Hamburg-Eppendorf; Germany
| | - Volker Harth
- Institute for Occupational and Maritime Medicine; ZfAM; University Medical Center Hamburg-Eppendorf; Germany
| | - Ulf Manuwald
- Health Sciences/Public Health; Carl Gustav Carus Technische Universität; Dresden Germany
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Winkler A, Plugfelder A, Weide B, Leiter U, Held L, Garbe C, Eigentler T. Screening for skin cancer in bank and insurance employees: risk profile and correlation of self and physician's assessment. Int J Dermatol 2015; 54:419-23. [DOI: 10.1111/ijd.12360] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Angelika Winkler
- Department of Dermatology; University-Hospital-Tübingen; Tübingen Germany
| | - Annette Plugfelder
- Department of Dermatology; University-Hospital-Tübingen; Tübingen Germany
| | - Benjamin Weide
- Department of Dermatology; University-Hospital-Tübingen; Tübingen Germany
| | - Ulrike Leiter
- Department of Dermatology; University-Hospital-Tübingen; Tübingen Germany
| | - Laura Held
- Department of Dermatology; University-Hospital-Tübingen; Tübingen Germany
| | - Claus Garbe
- Department of Dermatology; University-Hospital-Tübingen; Tübingen Germany
| | - Thomas Eigentler
- Department of Dermatology; University-Hospital-Tübingen; Tübingen Germany
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Spaan M, van den Belt-Dusebout AW, Schaapveld M, Mooij TM, Burger CW, van Leeuwen FE. Melanoma risk after ovarian stimulation for in vitro fertilization. Hum Reprod 2015; 30:1216-28. [PMID: 25743782 DOI: 10.1093/humrep/dev023] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2014] [Accepted: 01/22/2015] [Indexed: 12/14/2022] Open
Abstract
STUDY QUESTION Do women treated with ovarian stimulation for IVF have an increased risk of melanoma? SUMMARY ANSWER Ovarian stimulation for IVF does not increase risk of melanoma, even after a prolonged follow-up. WHAT IS KNOWN ALREADY Although exposure to ultraviolet radiation is the major risk factor for melanoma, associations between female sex steroids and melanoma risk have also been suggested. The results of available studies on fertility drugs and melanoma risk are inconclusive since most studies had several methodological limitations such as short follow-up, a small number of cases and no subfertile comparison group. STUDY DESIGN, SIZE, DURATION In 1996, a nationwide historic cohort study (the OMEGA-cohort) was established to examine the risk of cancer after ovarian stimulation for IVF. After a median follow-up of 17 years, cancer incidence was ascertained through linkage with the Netherlands Cancer Registry. Melanoma risk in the cohort was compared with that in the general population and between the IVF group and non-IVF group using multivariable Cox regression analyses. PARTICIPANTS/MATERIALS, SETTING, METHODS The cohort comprises 19 158 women who received IVF between 1983 and 1995 and a comparison group of 5950 women who underwent subfertility treatments other than IVF. Detailed IVF-treatment data were obtained from the medical records and complete information on parity and age at first birth was obtained through linkage with the Dutch Municipal Personal Records Database. MAIN RESULTS AND THE ROLE OF CHANCE In total, 93 melanoma cases were observed. The risk of melanoma was not elevated among IVF-treated women, neither when compared with the general population (standardized incidence ratio = 0.89; 95% confidence interval (CI): 0.69-1.12), nor when compared with the non-IVF group (adjusted hazard ratio (HR) = 1.27; 95% CI: 0.75-2.15). A higher number of IVF cycles was associated with apparent but statistically non-significant risk increases (5-6 cycles HR = 1.92; ≥7 cycles HR = 1.79). However, no significant trend emerged. In women with more follicle stimulating hormone/human menopausal gonadotrophin ampoules comparable non-significant risk increases were found. A longer follow-up did not increase melanoma risk. Nulliparous women did not have a significantly higher melanoma risk than parous women (HR = 1.22; 95% CI: 0.81-1.84). However, women who were 30 years of age or older at first birth had a significantly higher melanoma risk than women who were younger than 30 years at first birth (age: 30-34 years HR = 4.57; 95% CI: 2.07-10.08, >34 years HR = 2.98; 95% CI: 1.23-7.21). LIMITATIONS, REASONS FOR CAUTION Despite our large cohort, the number of melanoma cases was rather small, especially in our comparison group, which hampered subgroup analyses. WIDER IMPLICATIONS OF THE FINDINGS Our results are reassuring for women who underwent IVF or are contemplating to start IVF. Since our cohort study is one of the largest published so far, with long-term follow-up, a subfertile comparison group, and detailed IVF-treatment data, our results add important information to the available evidence. STUDY FUNDING/COMPETING INTEREST This study was supported by grants from the Dutch Cancer Society (NKI 2006-3631), the Health Research and Development Counsel (28-2540) and the Dutch Ministry of Health.
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Affiliation(s)
- M Spaan
- Department of Epidemiology, The Netherlands Cancer Institute, Plesmanlaan 121, Amsterdam, CX 1066, The Netherlands
| | - A W van den Belt-Dusebout
- Department of Epidemiology, The Netherlands Cancer Institute, Plesmanlaan 121, Amsterdam, CX 1066, The Netherlands
| | - M Schaapveld
- Department of Epidemiology, The Netherlands Cancer Institute, Plesmanlaan 121, Amsterdam, CX 1066, The Netherlands
| | - T M Mooij
- Department of Epidemiology, The Netherlands Cancer Institute, Plesmanlaan 121, Amsterdam, CX 1066, The Netherlands
| | - C W Burger
- Department of Obstetrics and Gynaecology, Erasmus Medical Center, Postbus 2040, Rotterdam, CA 3000, The Netherlands
| | - F E van Leeuwen
- Department of Epidemiology, The Netherlands Cancer Institute, Plesmanlaan 121, Amsterdam, CX 1066, The Netherlands
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Vanos JK. Children's health and vulnerability in outdoor microclimates: A comprehensive review. ENVIRONMENT INTERNATIONAL 2015; 76:1-15. [PMID: 25497108 DOI: 10.1016/j.envint.2014.11.016] [Citation(s) in RCA: 49] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/19/2014] [Revised: 11/23/2014] [Accepted: 11/25/2014] [Indexed: 05/20/2023]
Abstract
BACKGROUND Children are routinely identified as a vulnerable population in environmental health risk assessments, experiencing adverse health outcomes due to exposure to a suite of atmospheric constituents. OBJECTIVE To provide a substantive overview of the research literature pertaining to biometeorological effects on children. Key information areas within urban environmental health research related to atmospheric variables (heat, air pollution, radiation) are assessed and integrated to better understand health outcomes and vulnerabilities in children. Critical avenues for improvement and understanding of children's health related to such biophysical parameters are also identified. METHODS This comprehensive review assesses past and current primary studies, organizational reports, educational books, and review articles. Emphasis is placed on the differential ambient exposures to temperature, air pollution, and radiation within urban microclimates commonly used by children (e.g., schoolyards, urban parks), and the resulting health impacts. DISCUSSION Exposure to heat, air pollution, and radiation are often enhanced in urban areas, specifically under the current design of the majority of outdoor child play places. Many heat indices, energy budget models, and health outcome studies fail to adequately parameterize children, yet those that do find enhanced vulnerability to ambient stressors, particularly heat and air pollution. Such environmental exposures relate strongly to behavior, activity, asthma, obesity, and overall child well-being. Current research indicates that a changing climate, growing urban population, and unsustainable design are projected to pose increasing complications. CONCLUSIONS Evidence-based research to link children's health, physiology, and behavior to atmospheric extremes is an important future research avenue, underscoring the fact that children are among the population groups disproportionately affected by ambient extremes. However, current methods and population-based models lack child-specific inputs and outputs, as well as designated thresholds for accurate predictions of child health impacts. More substantive evidence is needed for applicable child-specific policies and guidelines.
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Affiliation(s)
- Jennifer K Vanos
- Atmospheric Sciences Research Group, Department of Geosciences, Texas Tech University, Lubbock, TX 79409-1053, USA.
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Bhattacharya T, Mohan GC, Silverberg JI. Attitudes, knowledge, and practices regarding sun safety among third to fifth graders from Chicago-area schools. J Am Acad Dermatol 2015; 72:554-555.e2. [PMID: 25687311 DOI: 10.1016/j.jaad.2014.11.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2014] [Revised: 11/02/2014] [Accepted: 11/04/2014] [Indexed: 10/24/2022]
Affiliation(s)
- Tanya Bhattacharya
- Department of Dermatology, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Girish C Mohan
- Department of Dermatology, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Jonathan I Silverberg
- Department of Dermatology, Northwestern University Feinberg School of Medicine, Chicago, Illinois; Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois; Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, Illinois.
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79
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Lei Z, Liu T, Li X, Xu X, Fan D. Contribution of glutathione S-transferase gene polymorphisms to development of skin cancer. Int J Clin Exp Med 2015; 8:377-386. [PMID: 25785008 PMCID: PMC4358463] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2014] [Accepted: 01/14/2015] [Indexed: 06/04/2023]
Abstract
BACKGROUND Glutathione S-transferase (GST) family genes are of vital importance in maintaining cellular defence systems, protecting cells against the toxic effects of reactive oxygen produced during the synthesis of melanin, and detoxifying environmental mutagens and chemical or synthetic drugs. As no previous meta-analyses have examined the association of polymorphisms at GSTT1, GSTP1 Ile105Val with skin cancer risk and independently published studies have produced inconsistent conclusions, we were promoted to estimate the associations in the largest study to date. METHODS Computer-assisted searches were carried out to systematically identify the studies of GST polymorphisms and skin cancer. The eligibility of studies was evaluated following the requirements of inclusion criteria. Risk of skin cancers (OR and 95% CI) was assessed with the fixed or random effects meta-analysis. MAJOR FINDINGS The fixed effects meta-analysis of 15 studies suggested no overall association between GSTT1 null and skin cancer. Nor was there a significant association in any subgroup. However, in the stratified analysis by histologic type for GSTP1 Ile105Val, we found 1.56 times higher risk of malignant melanoma (MM) among people with the 105-Val/Val genotype (Val/Val vs. Ile/Ile: OR = 1.56, 95% CI = 1.05-2.32, pheterogeneity = 0.584). CONCLUSIONS These statistical data demonstrate that Ile105Val polymorphism of the GSTP1 gene may have genetic contribution to the development of skin cancer, MM in particular.
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Affiliation(s)
- Zeyuan Lei
- Department of Plastic and Cosmetic Surgery, Xinqiao Hospital, The Third Military Medical University Chongqing 400037, China
| | - Ting Liu
- Department of Plastic and Cosmetic Surgery, Xinqiao Hospital, The Third Military Medical University Chongqing 400037, China
| | - Xiang Li
- Department of Plastic and Cosmetic Surgery, Xinqiao Hospital, The Third Military Medical University Chongqing 400037, China
| | - Xiaoxia Xu
- Department of Plastic and Cosmetic Surgery, Xinqiao Hospital, The Third Military Medical University Chongqing 400037, China
| | - Dongli Fan
- Department of Plastic and Cosmetic Surgery, Xinqiao Hospital, The Third Military Medical University Chongqing 400037, China
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80
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Glanz K, Escoffery C, Elliott T, Nehl EJ. Randomized Trial of Two Dissemination Strategies for a Skin Cancer Prevention Program in Aquatic Settings. Am J Public Health 2014; 105:1415-23. [PMID: 25521872 DOI: 10.2105/ajph.2014.302224] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVES We compared 2 strategies for disseminating an evidence-based skin cancer prevention program. METHODS We evaluated the effects of 2 strategies (basic vs enhanced) for dissemination of the Pool Cool skin cancer prevention program in outdoor swimming pools on (1) program implementation, maintenance, and sustainability and (2) improvements in organizational and environmental supports for sun protection. The trial used a cluster-randomized design with pools as the unit of intervention and outcome. The enhanced group received extra incentives, reinforcement, feedback, and skill-building guidance. Surveys were collected in successive years (2003-2006) from managers of 435 pools in 33 metropolitan areas across the United States participating in the Pool Cool Diffusion Trial. RESULTS Both treatment groups improved their implementation of the program, but pools in the enhanced condition had significantly greater overall maintenance of the program over 3 summers of participation. Furthermore, pools in the enhanced condition established and maintained significantly greater sun-safety policies and supportive environments over time. CONCLUSIONS This study found that more intensive, theory-driven dissemination strategies can significantly enhance program implementation and maintenance of health-promoting environmental and policy changes. Future research is warranted through longitudinal follow-up to examine sustainability.
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Affiliation(s)
- Karen Glanz
- Karen Glanz is with Perelman School of Medicine and School of Nursing, University of Pennsylvania, Philadelphia. Cam Escoffery, Tom Elliott, and Eric J. Nehl are with Rollins School of Public Health, Emory University, Atlanta, GA
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Abstract
A new or changing melanocytic nevus in a child or adolescent often leads to concern in parents and physicians. To avoid undue alarm and unnecessary procedures, dermatologists should be aware of the natural history and clinical spectrum of nevi in pediatric patients, as well as findings that are potentially worrisome in this age group. This review provides an update on melanocytic nevi in children, focusing on their dynamic evolution over time, molecular insights into nevogenesis, and phenotypic markers for increased risk of melanoma in adolescence and adulthood. Special considerations for Spitz nevi and nevi located in particular sites (eg, scalp, acral, genital) are highlighted. Current understanding of the risks associated with congenital melanocytic nevi of different sizes and strategies for the management of children with numerous acquired nevi, Spitz nevi, and congenital nevi are also discussed.
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82
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Van Osch L, Reubsaet A, Lechner L, Candel M, Mercken L, De Vries H. Predicting parental sunscreen use: Disentangling the role of action planning in the intention-behavior relationship. Psychol Health 2014; 23:829-47. [PMID: 25160883 DOI: 10.1080/08870440701596577] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Structural equation modeling was used to examine antecedents of parental sunscreen use (N = 436) in a longitudinal design. The influence of a volitional planning cognition was assessed in several path models, investigating potential mediation and moderation of the intention-behavior relationship. Premotivational and motivational variables accounted for 55.1% of the variance in intention to use sunscreen. Intention emerged as the most powerful predictor of behavior, followed by action planning and self-efficacy expectations, together explaining 35.4% of parental sunscreen use after five months. Strong support was found for both mediating and moderating influences of action planning on the intention-behavior relationship. Action planning also partially mediated the impact of self-efficacy on behavior. The results support theoretical considerations to add postintentional cognitions to current health behavior models. Although action planning is an important component in the transition from intention to behavior, the impact of intention and of other premotivational and motivational variables should not be overlooked when developing health educational interventions.
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Affiliation(s)
- Liesbeth Van Osch
- a School for Public Health and Primary Care (Caphri) , Department of Health Education and Health Promotion , Maastricht University , The Netherlands
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83
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Shanmugalingam T, Crawley D, Bosco C, Melvin J, Rohrmann S, Chowdhury S, Holmberg L, Van Hemelrijck M. Obesity and cancer: the role of vitamin D. BMC Cancer 2014; 14:712. [PMID: 25255691 PMCID: PMC4182855 DOI: 10.1186/1471-2407-14-712] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2014] [Accepted: 08/21/2014] [Indexed: 12/14/2022] Open
Abstract
Background It is estimated that 20% of all cancer cases are caused by obesity. Vitamin D is thought to be one of the mechanisms underlying this association. This review aims to summarise the evidence for the mediating effect of vitamin D on the link between obesity and cancer. Methods Three literature searches using PubMed and Embase were conducted to assess whether vitamin D plays an important role in the pathway between obesity and cancer: (1) obesity and cancer; (2) obesity and vitamin D; and (3) vitamin D and cancer. A systematic review was performed for (1) and (3), whereas a meta-analysis including random effects analyses was performed for (2). Results (1) 32 meta-analyses on obesity and cancer were identified; the majority reported a positive association between obesity and risk of cancer. (2) Our meta-analysis included 12 original studies showing a pooled relative risk of 1.52 (95% CI: 1.33-1.73) for risk of vitamin D deficiency (<50 nmol/L) in obese people (body mass index >30 kg/m2). (3) 21 meta-analyses on circulating vitamin D levels and cancer risk were identified with different results for different types of cancer. Conclusion There is consistent evidence for a link between obesity and cancer as well as obesity and low vitamin D. However, it seems like the significance of the mediating role of vitamin D in the biological pathways linking obesity and cancer is low. There is a need for a study including all three components while dealing with bias related to dietary supplements and vitamin D receptor polymorphisms. Electronic supplementary material The online version of this article (doi:10.1186/1471-2407-14-712) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Thurkaa Shanmugalingam
- King's College London, School of Medicine, Division of Cancer Studies, Cancer Epidemiology Group, London, UK.
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84
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Gould M, Farrar MD, Kift R, Berry JL, Mughal MZ, Bundy C, Vail A, Webb AR, Rhodes LE. Sunlight exposure and photoprotection behaviour of white Caucasian adolescents in the UK. J Eur Acad Dermatol Venereol 2014; 29:732-7. [PMID: 25185510 DOI: 10.1111/jdv.12669] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2014] [Accepted: 02/07/2014] [Indexed: 11/28/2022]
Abstract
BACKGROUND Sun exposure has positive and negative effects on health, yet little is known about the sun exposure behaviour of UK adolescents, including those more prone or less prone to sunburn. OBJECTIVE To examine sun exposure behaviour of UK white Caucasian adolescents including time spent outdoors, holiday behaviour, use of sunscreen and clothing, with assessment for differences between sun-reactive skin type groups. METHODS White Caucasian adolescents (12-15 years) attending schools in Greater Manchester completed a two-page questionnaire to assess sun exposure and photoprotective behaviour. RESULTS A total of 133 adolescents (median age 13.4 years; 39% skin type I/II, 61% skin type III/IV) completed the questionnaire. In summer, adolescents spent significantly longer outdoors at weekends (median 4 h/day, range 0.25-10) than on weekdays (2, 0.25-6; P < 0.0001). When at home in the UK during summer, 44% reported never wearing sunscreen compared to just 1% when on a sunny holiday. Sunscreen use was also greater (frequency/coverage) when on a sunny holiday than at home in the UK summer (P < 0.0001). Adolescents of skin types I/II (easy burning) spent significantly less time outdoors than skin types III/IV (easy tanning) on summer weekends (P < 0.001), summer weekdays (P < 0.05) and on a sunny holiday (P = 0.001). Furthermore, skin types I/II reported greater sunscreen use during summer in the UK and on sunny holiday (both P < 0.01), and wore clothing covering a greater skin area on a sunny holiday (P < 0.01) than skin types III/IV. There was no difference in sun exposure behaviour/protection between males and females. CONCLUSION The greater sun-protective measures reported by adolescents of sun-reactive skin type group I/II than III/IV suggest those who burn more easily are aware of the greater need to protect their skin. However, use of sunscreen during the UK summer is low and may need more effective promotion in adolescents.
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Affiliation(s)
- M Gould
- Centre for Dermatology, Institute of Inflammation and Repair, University of Manchester, Manchester, UK; Manchester Academic Health Science Centre, Salford Royal NHS Foundation Hospital, Manchester, UK
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85
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Crump C, Sundquist K, Sieh W, Winkleby MA, Sundquist J. Season of birth and other perinatal risk factors for melanoma. Int J Epidemiol 2014; 43:793-801. [PMID: 24453238 PMCID: PMC4052134 DOI: 10.1093/ije/dyt277] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/17/2013] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Ultraviolet radiation (UVR) exposure is the main risk factor for cutaneous malignant melanoma (CMM), but its specific effect in infancy is unknown. We examined whether season of birth, a proxy for solar UVR exposure in the first few months of life, is associated with CMM in childhood through young adulthood. METHODS National cohort study of 3,571,574 persons born in Sweden in 1973-2008, followed up for CMM incidence through 2009 (maximum age 37 years) to examine season of birth and other perinatal factors. RESULTS There were 1595 CMM cases in 63.9 million person-years of follow-up. We found a sinusoidal pattern in CMM risk by season of birth (P=0.006), with peak risk corresponding to birthdates in spring (March-May). Adjusted odds ratios for CMM by season of birth were 1.21 [95% confidence interval (CI), 1.05-1.39; P=0.008] for spring, 1.07 (95% CI, 0.92-1.24; P=0.40) for summer and 1.12 (95% CI, 0.96-1.29; P=0.14) for winter, relative to fall. Spring birth was associated with superficial spreading subtype of CMM (P=0.02), whereas there was no seasonal association with nodular subtype (P=0.26). Other CMM risk factors included family history of CMM in a sibling (>6-fold) or parent (>3-fold), female gender, high fetal growth and high paternal education level. CONCLUSIONS In this large cohort study, persons born in spring had increased risk of CMM in childhood through young adulthood, suggesting that the first few months of life may be a critical period of UVR susceptibility. Sun avoidance in early infancy may play an important role in the prevention of CMM in high-risk populations.
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Affiliation(s)
- Casey Crump
- Department of Medicine, Stanford University, Stanford, CA, USA, Center for Primary Health Care Research, Lund University, Malmö, Sweden, Stanford Prevention Research Center, Stanford University, Stanford, CA, USA and Department of Health Research and Policy, Stanford University, Stanford, CA, USA
| | - Kristina Sundquist
- Department of Medicine, Stanford University, Stanford, CA, USA, Center for Primary Health Care Research, Lund University, Malmö, Sweden, Stanford Prevention Research Center, Stanford University, Stanford, CA, USA and Department of Health Research and Policy, Stanford University, Stanford, CA, USADepartment of Medicine, Stanford University, Stanford, CA, USA, Center for Primary Health Care Research, Lund University, Malmö, Sweden, Stanford Prevention Research Center, Stanford University, Stanford, CA, USA and Department of Health Research and Policy, Stanford University, Stanford, CA, USA
| | - Weiva Sieh
- Department of Medicine, Stanford University, Stanford, CA, USA, Center for Primary Health Care Research, Lund University, Malmö, Sweden, Stanford Prevention Research Center, Stanford University, Stanford, CA, USA and Department of Health Research and Policy, Stanford University, Stanford, CA, USA
| | - Marilyn A Winkleby
- Department of Medicine, Stanford University, Stanford, CA, USA, Center for Primary Health Care Research, Lund University, Malmö, Sweden, Stanford Prevention Research Center, Stanford University, Stanford, CA, USA and Department of Health Research and Policy, Stanford University, Stanford, CA, USA
| | - Jan Sundquist
- Department of Medicine, Stanford University, Stanford, CA, USA, Center for Primary Health Care Research, Lund University, Malmö, Sweden, Stanford Prevention Research Center, Stanford University, Stanford, CA, USA and Department of Health Research and Policy, Stanford University, Stanford, CA, USADepartment of Medicine, Stanford University, Stanford, CA, USA, Center for Primary Health Care Research, Lund University, Malmö, Sweden, Stanford Prevention Research Center, Stanford University, Stanford, CA, USA and Department of Health Research and Policy, Stanford University, Stanford, CA, USA
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86
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Wu S, Jin C, Lu X, Yang J, Liu Q, Qi M, Lu S, Zhang L, Cai Y. Bystander effect induced by UVC radiation in Chinese hamster V79 cells. Photochem Photobiol 2014; 90:837-44. [PMID: 24517728 DOI: 10.1111/php.12255] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2013] [Accepted: 01/29/2014] [Indexed: 11/26/2022]
Abstract
In past decades, researches on radiation-induced bystander effect mainly focused on ionizing radiation such as α-particle, β-particle, X-ray and γ-ray. But few researches have been conducted on the ability of ultraviolet (UV) radiation-induced bystander effect, and knowledge of UVC-induced bystander effect is far limited. Here, we adopted medium transfer experiment to detect whether UVC could cause bystander effect in Chinese hamster V79 cells. We determined the cell viability, apoptosis rate, chromosome aberration and ultrastructure changes, respectively. Our results showed that: (1) the viability of UVC-irradiated V79 cells declined significantly with the dosage of UVC; (2) similar to the irradiated cells, the main death type of bystander cells cultured in irradiation conditioned medium (ICMs) was also apoptosis; (3) soluble factors secreted by UVC-irradiated cells could induce bystander effect in V79 cells; (4) cells treated with 4 h ICM collected from 90 mJ cm(-2) UVC-irradiated cells displayed the strongest response. Our data revealed that UVC could cause bystander effect through the medium soluble factors excreted from irradiated cells and this bystander effect was a novel quantitative and kinetic response. These findings might provide a foundation to further explore the exact soluble bystander factors and detailed mechanism underlying UVC-induced bystander effect.
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Affiliation(s)
- Shengwen Wu
- Department of Toxicology, School of Public Health, China Medical University, Shenyang, China; Department of Occupational and Environmental Health, School of Public Health, China Medical University, Shenyang, China
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Haluza D, Simic S, Höltge J, Cervinka R, Moshammer H. Connectedness to nature and public (skin) health perspectives: results of a representative, population-based survey among Austrian residents. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2014; 11:1176-91. [PMID: 24448634 PMCID: PMC3924498 DOI: 10.3390/ijerph110101176] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/12/2013] [Revised: 01/13/2014] [Accepted: 01/13/2014] [Indexed: 11/25/2022]
Abstract
Connectedness to nature (CN) influences motivation to have contact with outdoor natural environments. Spending leisure time in natural environments is beneficial for human health and well-being. Besides these positive effects, health risks of open-air activities are mainly related to unprotected sun light exposure-associated acute and chronic skin hazards. Thus, we conducted a cross-sectional, representative telephone survey among Austrian residents to study the association of perceived CN level with sun-exposure knowledge, tanning habits, and sun protective behaviour. In total, 1,500 study subjects (50.5% females) participated in this questionnaire survey. Although knowledge about tanning and motives to tan were similar among genders, females performed more photoprotective measures and were more connected to nature (all p < 0.001) compared to males. Older age and outdoor sport were significant gender-independent predictor variables influencing perceived CN level. Additionally, level of education was relevant in male CN, whereas non-smoking and higher knowledge were predictive of female CN. This survey provides so far unreported empirical data on the relationship between nature connectedness and skin health-relevant recreational habits of Austrian residents. The findings suggest to integrate hitherto neglected gender-specific Public (Skin) Health promotion when counselling on the manifold health advantages of outdoor activities.
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Affiliation(s)
- Daniela Haluza
- Institute of Environmental Health, Center for Public Health, Medical University of Vienna, Kinderspitalgasse 15, A-1090 Vienna, Austria.
| | - Stana Simic
- Institute of Environmental Health, Center for Public Health, Medical University of Vienna, Kinderspitalgasse 15, A-1090 Vienna, Austria.
| | - Jan Höltge
- Institute of Environmental Health, Center for Public Health, Medical University of Vienna, Kinderspitalgasse 15, A-1090 Vienna, Austria.
| | - Renate Cervinka
- Institute of Environmental Health, Center for Public Health, Medical University of Vienna, Kinderspitalgasse 15, A-1090 Vienna, Austria.
| | - Hanns Moshammer
- Institute of Environmental Health, Center for Public Health, Medical University of Vienna, Kinderspitalgasse 15, A-1090 Vienna, Austria.
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Haluza D, Simic S, Moshammer H. Temporal and spatial melanoma trends in Austria: an ecological study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2014; 11:734-48. [PMID: 24398911 PMCID: PMC3924471 DOI: 10.3390/ijerph110100734] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/14/2013] [Revised: 12/23/2013] [Accepted: 12/24/2013] [Indexed: 11/17/2022]
Abstract
Annual solar ultraviolet radiation (UVR) is mostly determined by latitude and altitude. Over the last decades, increasing UVR ground levels have been observed. Exposure to UVR is associated with a life-time risk to develop melanoma, a malign skin cancer. Thus, we hypothesized that melanoma incidence in Austria is associated with altitude of place of living and time of diagnosis. We investigated this hypothesis in an ecological study by district and year for Austrian melanoma incidence (1990-2010) and mortality (1970-2011) data. As expected, incidence rates increased with altitude (about 2% per 10 m) and year (about 2%). Additionally, melanoma incidence rates were about 50% higher in urban than in rural districts. In contrast, mortality rates decreased with altitude (for males: 0.4% per 10 m, for women: 0.7% per 10 m, respectively). The observed discrepancy between incidence and mortality data could partly be explained by melanoma diagnosis at earlier tumor stage in districts with higher altitude. Possible reasons for this finding include higher awareness of patients, better diagnostic performance of medical professionals working at higher altitudes, or slower tumor growth due to protective effects of sun light-associated vitamin D synthesis.
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Affiliation(s)
- Daniela Haluza
- Center for Public Health, Institute of Environmental Health, Medical University of Vienna, Kinderspitalgasse 15, Vienna A-1090, Austria.
| | - Stana Simic
- Center for Public Health, Institute of Environmental Health, Medical University of Vienna, Kinderspitalgasse 15, Vienna A-1090, Austria.
| | - Hanns Moshammer
- Center for Public Health, Institute of Environmental Health, Medical University of Vienna, Kinderspitalgasse 15, Vienna A-1090, Austria.
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Arg72Pro polymorphism of TP53 gene and the risk of skin cancer: a meta-analysis. PLoS One 2013; 8:e79983. [PMID: 24260330 PMCID: PMC3832645 DOI: 10.1371/journal.pone.0079983] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2013] [Accepted: 09/27/2013] [Indexed: 11/26/2022] Open
Abstract
Background TP53 gene is one of the most important tumor suppressor genes. We undertook this meta-analysis to explore the association between TP53 Arg72Pro polymorphism and the risk of skin cancer mainly in Caucasians. Methods We searched PubMed for case-control studies published up to March 2013. Odds ratios (ORs) with 95% confidence intervals (CIs) were used to assess the strength of association. Results A total of 5276 skin cancer cases and 5315 controls from 20 studies were included. Overall, no significant association between TP53 Arg72Pro polymorphism and skin cancer was observed in all genetic contrast models (Pro/Pro versus Arg/Arg, Pro/Arg versus Arg/Arg, Pro/Pro + Pro/Arg versus Arg/Arg, Pro/Pro versus Arg/Arg + Pro/Arg, Pro allele versus Arg allele). Similar results were obtained in the stratified analysis by ethnicity and histological types of skin cancer, such as melanoma, squamous cell carcinoma and basal cell carcinoma. Power calculations indicated that some studies were underpowered. No publication bias was found by using the funnel plot and Egger's test. Conclusions This meta-analysis indicated that TP53 Arg72Pro polymorphism probably had little association with skin cancer susceptibility mainly in Caucasians. However, larger sample-size studies are required to verify the conclusion as low statistical powers.
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90
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Oldenburg M, Kuechmeister B, Ohnemus U, Baur X, Moll I. Actinic keratosis among seafarers. Arch Dermatol Res 2013; 305:787-96. [PMID: 23818098 DOI: 10.1007/s00403-013-1384-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2013] [Revised: 06/10/2013] [Accepted: 06/20/2013] [Indexed: 10/26/2022]
Abstract
The aim of this study was to assess the prevalence of UV-induced actinic keratosis and further skin lesions. A newly developed questionnaire about lifetime UV radiation exposure was completed by 514 seafarers. An experienced dermatologist inspected the whole-body skin status of all participants. The questionnaire revealed a pre-employment UV radiation exposure in 104 seafarers, sunbed use in 26 subjects and a median work-related UV radiation exposure at sea of 20 years. The diagnosis of actinic keratoses was made in 94 seafarers and the clinical diagnosis of skin cancers in 48 seafarers (28 basal cell carcinoma, 11 squamous cell carcinoma, 9 malignant melanoma). After age standardisation according to a European reference population, the male European seafarers in this study had a 1.80-fold increased risk of actinic keratosis. Actinic keratoses [OR 1.03 (1.01-1.05)] and squamous cell carcinoma [OR 1.07 (1.01-1.13)] were related to the duration of seafaring time in years. A significant association was also found between actinic keratosis/squamous cell carcinoma and sunlight exposure during home leave [OR 1.67 (1.03-2.81) and OR 6.19 (1.18-32.40)]. Furthermore, the engine room personnel-especially the technical officers-were at higher risk of developing actinic keratosis. Due to the high prevalence of actinic keratosis especially among older seafarers with fair skin, with longer duration of seafaring employment at sea and with higher UV exposure during home leave, more intensive advice should be given on sun protection both at sea and ashore.
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Affiliation(s)
- M Oldenburg
- Hamburg State Department for Health and Consumer Protection, Institute for Occupational and Maritime Medicine, University Medical Center Hamburg-Eppendorf, Seewartenstrasse 10, 20459, Hamburg, Germany,
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91
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Everett Jones S, O'Malley Olsen E, Michael SL, Saraiya M. Association of UV index and sunscreen use among White high school students in the United States. THE JOURNAL OF SCHOOL HEALTH 2013; 83:750-756. [PMID: 24020690 DOI: 10.1111/josh.12090] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/14/2012] [Revised: 01/22/2013] [Accepted: 02/15/2013] [Indexed: 06/02/2023]
Abstract
BACKGROUND When used appropriately, sunscreen decreases the amount of ultraviolet (UV) radiation exposure to the skin and is recommended to prevent skin cancer. This study examined the association between annual average UV index and sunscreen use among White, non-Hispanic youth. METHODS The 2007 and 2009 national Youth Risk Behavior Survey (YRBS) data were analyzed. The YRBS is a school-based, cross-sectional study that uses a 3-stage cluster sample design to obtain a nationally representative sample of public and private high school students in the United States. Overall response rates were 68% and 72% (N = 14,041 and 16,410, respectively). Logistic regression analyzes, controlling for grade, examined whether annual average (mean) UV index where students attend school, a proxy measure of potential sunlight exposure, was associated with sunscreen use. RESULTS Among White male students, as the mean UV index increased, the adjusted odds of never wearing sunscreen increased (adjusted odds ratio, AOR = 1.15 [95% CI = 1.04, 1.27], p < .01) and the adjusted odds of most of the time or always wearing sunscreen decreased (AOR = 0.85 [0.78, 0.94], p < .01). There was no association between sunscreen use and mean UV index among White female students. CONCLUSION These findings suggest a need for renewed public health efforts among school, clinical, and public health professionals to promote sunscreen use as part of a comprehensive approach to prevent skin cancer. School and community approaches that passively protect young people from the sun should be considered as a complement to efforts to increase sunscreen use.
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Affiliation(s)
- Sherry Everett Jones
- Health Scientist, , Division of Adolescent and School Health, Centers for Disease Control and Prevention, 4770 Buford Hwy, NE, MS K29, Atlanta, GA 30341
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92
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Preventing skin cancer through reduction of indoor tanning: current evidence. Am J Prev Med 2013; 44:682-9. [PMID: 23683987 PMCID: PMC4535424 DOI: 10.1016/j.amepre.2013.02.015] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2012] [Revised: 02/28/2013] [Accepted: 02/28/2013] [Indexed: 12/31/2022]
Abstract
Exposure to ultraviolet radiation from indoor tanning devices (tanning beds, booths, and sun lamps) or from the sun contributes to the risk of skin cancer, including melanoma, which is the type of skin cancer responsible for most deaths. Indoor tanning is common among certain groups, especially among older adolescents and young adults, adolescent girls and young women, and non-Hispanic whites. Increased understanding of the health risks associated with indoor tanning has led to many efforts to reduce use. Most environmental and systems efforts in the U.S. (e.g., age limits or requiring parental consent/accompaniment) have occurred at the state level. At the national level, the U.S. Food and Drug Administration and the Federal Trade Commission regulate indoor tanning devices and advertising, respectively. The current paper provides a brief review of (1) the evidence on indoor tanning as a risk factor for skin cancer; (2) factors that may influence use of indoor tanning devices at the population level; and (3) various environmental and systems options available for consideration when developing strategies to reduce indoor tanning. This information provides the context and background for the companion paper in this issue of the American Journal of Preventive Medicine, which summarizes highlights from an informal expert meeting convened by the CDC in August 2012 to identify opportunities to prevent skin cancer by reducing use of indoor tanning devices.
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93
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Lee MS, Lin RY, Chang YT, Lai MS. The risk of developing non-melanoma skin cancer, lymphoma and melanoma in patients with psoriasis in Taiwan: a 10-year, population-based cohort study. Int J Dermatol 2013; 51:1454-60. [PMID: 23171012 DOI: 10.1111/j.1365-4632.2011.05310.x] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
BACKGROUND Hospitalized psoriasis patients are known to have a higher risk of malignancy (e.g., nonmelanoma skin cancer [NMSC], lymphoma, and melanoma) than the general population; currently, it is unclear whether this risk is affected by psoriasis severity. The aim of this study was to compare the cancer risk of patients with mild and severe psoriasis and the general population. METHODS Data for this retrospective population-based cohort study were obtained from the Taiwan National Health Insurance Research Database. This study included 7061 patients with a first-time diagnosis of psoriasis. All study individuals were followed up until the end of 2007. The crude incidence density ratio and standardized incidence ratio (SIR) of NMSC, melanoma, and lymphoma were determined. RESULTS Among psoriasis patients, the most common cancer was NMSC (density ratio: 7.5); women were at a higher risk of NMSC than men (density ratios: 8.08 vs. 7.0). Psoriasis patients in the south geographic group or in the 50- to 59-year-old age group were most likely to develop NMSC. The NMSC SIR was higher among patients with severe psoriasis than among patients with mild psoriasis (SIR: 3.72 vs. 7.08). The lymphoma and melanoma SIR among patients with severe psoriasis was also high (lymphoma SIR: 4.85; melanoma: 11.01). CONCLUSIONS Psoriasis carries an elevated risk of NMSC and lymphoma. This effect is modified by the severity of psoriasis, age, gender, and geographic location.
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Affiliation(s)
- Meng-Sui Lee
- Department of Dermatology, Taipei City Hospital, Taipei, Taiwan
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94
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Holman DM, Watson M. Correlates of intentional tanning among adolescents in the United States: a systematic review of the literature. J Adolesc Health 2013; 52:S52-9. [PMID: 23601612 PMCID: PMC4538996 DOI: 10.1016/j.jadohealth.2012.09.021] [Citation(s) in RCA: 63] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2012] [Revised: 09/13/2012] [Accepted: 09/18/2012] [Indexed: 12/16/2022]
Abstract
PURPOSE Exposure to ultraviolet radiation and a history of sunburn in childhood contribute to risk of skin cancer in adolescence and in adulthood, but many adolescents continue to seek a tan, either from the sun or from tanning beds (i.e., intentional tanning). To understand tanning behavior among adolescents, we conducted a systematic review of the literature to identify correlates of intentional tanning in the United States. METHODS We included articles on original research published in English between January 1, 2001, and October 31, 2011, that used self-reported data on intentional tanning by U.S. adolescents aged 8 to 18 years and examined potential correlates of tanning behaviors. Thirteen articles met our criteria; all used cross-sectional survey data and quantitative methods to assess correlates of intentional tanning. RESULTS Results indicate that multiple factors influence tanning among adolescents. Individual factors that correlated with intentional tanning include demographic factors (female sex, older age), attitudes (preferring tanned skin), and behaviors (participating in other risky or appearance-focused behaviors such as dieting). Social factors correlated with intentional tanning include parental influence (having a parent who tans or permits tanning) and peer influence (having friends who tan). Only four studies examined broad contextual factors such as indoor tanning laws and geographic characteristics; they found that proximity to tanning facilities and geographic characteristics (living in the Midwest or South, living in a low ultraviolet area, and attending a rural high school) are associated with intentional tanning. CONCLUSIONS These findings inform future public health research and intervention efforts to reduce intentional tanning.
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Affiliation(s)
- Dawn M Holman
- Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia 30341, USA.
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95
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Migration and melanoma incidence rates among Washington state counties. Melanoma Res 2013; 23:312-20. [PMID: 23598365 DOI: 10.1097/cmr.0b013e3283616783] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
The purpose of this study was to look for a possible explanation for the variation in the incidence rate of melanoma among counties in Washington state. We used data from the Washington State Cancer Registry (WSCR), the Cancer Center at PeaceHealth St. Joseph Hospital in Whatcom County, and the Surveillance, Epidemiology, and End Results registry to get information on melanoma incidence. Demographic and migration records were obtained from the US Census Bureau, the Washington State Department of Licensing (DOL), and the US Internal Revenue Service (IRS). A number of different analytic techniques were used to address our research question, including a multiple regression analysis, time trend comparisons, and an analysis of birthplace data of melanoma patients in Whatcom county. We found a significant association between migration rate from the Southwest (SW) USA and melanoma incidence (P<0.001). Plots of time trend show that melanoma rates track with migration from the SW. In Whatcom county, almost half of all residents were born outside of Washington state, but they accounted for about 70% of all melanoma cases. Our analyses suggest that migration from the SW is an important factor in explaining the variation in melanoma rate among counties in Washington.
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96
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Lucas RM, Valery P, van der Mei I, Dwyer T, Pender MP, Taylor B, Ponsonby AL. Sun Exposure over a Lifetime in Australian Adults from Latitudinally Diverse Regions. Photochem Photobiol 2013; 89:737-44. [DOI: 10.1111/php.12044] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2012] [Accepted: 01/08/2013] [Indexed: 11/30/2022]
Affiliation(s)
- Robyn M. Lucas
- National Centre for Epidemiology and Population Health; The Australian National University; Canberra; Australia
| | - Patricia Valery
- Menzies School of Health Research; Charles Darwin University; Darwin; Australia
| | | | - Terence Dwyer
- Murdoch Childrens Research Institute; Melbourne; Australia
| | - Michael P. Pender
- The University of Queensland and Royal Brisbane and Women's Hospital; Brisbane; Australia
| | - Bruce Taylor
- Menzies Research Institute Tasmania; Hobart; Australia
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Levine H, Afek A, Shamiss A, Derazne E, Tzur D, Astman N, Keinan-Boker L, Mimouni D, Kark JD. Country of origin, age at migration and risk of cutaneous melanoma: a migrant cohort study of 1,100,000 Israeli men. Int J Cancer 2013; 133:486-94. [PMID: 23319364 DOI: 10.1002/ijc.28031] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2012] [Accepted: 12/21/2012] [Indexed: 11/07/2022]
Abstract
Cutaneous melanoma (CM) is a common cancer with increasing incidence in many parts of the world where light-skinned populations live. We conducted a large-scale nationally representative migrant cohort study to assess country of origin and age at migration as predictors of CM, controlling for possible confounders. Data on 1,086,569 Israeli Jewish males, who underwent a general health examination before compulsory military service at ages 16-19 between the years 1967-2005, were linked to Israel National Cancer Registry to obtain incident CM up to 2006. Cox proportional hazards was used to model time to event. Overall, 1562 incident cases were detected during 19.3 million person-years of follow-up. Origin was a strong independent predictor of CM. Incidence was higher for European (hazard ratio [HR] = 4.08, 95% confidence interval [CI]: 3.55-4.67) and Israeli origin (HR = 2.92, 95% CI: 2.25-3.79) compared to N. African/Asian origin, adjusted for year of birth, years of education, residential socio-economic position, rural residence and body surface area (or height). Among those of European origin, the adjusted risk was significantly lower for those who immigrated after the age of 10 years (HR = 0.58, 95% CI: 0.45-0.73) but not for younger ages (HR = 1.02, 95% CI 0.84-1.23) compared to Israeli born. The high rates of CM among men of European origin and the almost twofold lower risk among those immigrating after age 10 provide solid support for the deleterious role of childhood sun exposure as a risk factor for melanoma. These findings will serve in directing public health and research efforts.
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98
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Glenn BA, Bastani R, Chang LC, Khanna R, Chen K. Sun protection practices among children with a family history of melanoma: a pilot study. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2012; 27:731-737. [PMID: 22610837 DOI: 10.1007/s13187-012-0377-5] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
The goal of this pilot study was to assess sun protection practices and correlates among children with a family history of melanoma, a high risk and understudied group. Sixty-eight melanoma cases, recruited through the Los Angeles County cancer registry, completed a survey. Survivors provided data on 110 children (mean age = 8.11 years). Although most children used sunscreen (79 %), half experienced a recent sunburn. The mean sun protection level for the sample was similar to levels observed among average risk children. Efforts to reduce sunburn frequency and improve sun protection among these vulnerable children appear warranted.
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Affiliation(s)
- Beth A Glenn
- Fielding School of Public Health and Jonsson Comprehensive Cancer Center, University of California, CHS, Los Angeles, CA 90095-6900, USA.
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99
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Sunscreen use and availability among female collegiate athletes. J Am Acad Dermatol 2012; 67:876.e1-6. [DOI: 10.1016/j.jaad.2011.11.962] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2011] [Revised: 11/15/2011] [Accepted: 11/27/2011] [Indexed: 11/22/2022]
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Reeder AI, Jopson JA, Gray A. Primary school sun protection policies and practices 4 years after baseline--a follow-up study. HEALTH EDUCATION RESEARCH 2012; 27:844-856. [PMID: 22907533 PMCID: PMC3442379 DOI: 10.1093/her/cys092] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/09/2011] [Accepted: 07/11/2012] [Indexed: 06/01/2023]
Abstract
Before the 2005 launch of the New Zealand SunSmart Schools Accreditation Programme (SSAP), 242 randomly sampled primary schools completed a mail survey about sun protection policies, practices, curriculum and environment. A 2009 follow-up included 189 (78%) and their mean Total Accreditation Score (TAS = total SSAP requirements met, range 0-12), increased by 0.8 (95% CI 0.5-1.2, P < 0.001) from 7.8 (95% CI 7.4-8.1) to 8.6 (95% CI 8.3-8.9) with evidence changes differed between regions (P = 0.024). The 2009 mean TAS varied by region (range 7.9-9.4, unadjusted P = 0.004, adjusted P = 0.013) with no clear pattern, but likely resource allocation association. TAS of schools acknowledging input from Health Promoting Schools demonstrated a tendency towards being statistically significantly higher by 0.5 (95% CI -0.1 to 1.1, P = 0.082), but statistically significantly higher by 1.1 (95% CI 0.5-1.7, P < 0.001) for schools acknowledging Cancer Society input. Lowest attainment was for the clothing (43%), shade (52%) and curriculum (55%) criteria. Key perceived barriers were cost, particularly of shade and limited support by parents and others. Schools which had not applied for accreditation identified lack of programme awareness and 'other priorities' as barriers; further information, better resourcing and training assistance as key needs. Observed positive change justifies increased support to consolidate gains and achieve sustainable universality.
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Affiliation(s)
- Anthony I Reeder
- Department of Preventive and Social Medicine, University of Otago, Cancer Society of New Zealand Social & Behavioural Research Unit, Dunedin School of Medicine, Dunedin, New Zealand.
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